Cataracts
Cataracts are a normal part of the aging process and are as common as wrinkles or graying of hair. However, unlike many other changes that occur as we age, cataracts can now be corrected in a way that offers the potential for greatly improved vision and with much less dependence on glasses.
Causes
The normal crystalline lens usually remains clear for many decades, but as it accumulates damage from UV light, metabolic changes, environmental and dietary toxins, radiation or simply aging, it becomes cloudy and darker, allowing less light to pass unobstructed to the retina. This leads to impaired vision and symptoms such as frequent glasses prescription changes, reduced night vision, increased problems with glare from on-coming traffic, fading of colors and difficulty reading. Although these changes can occur rapidly, they usually occur slowly and insidiously over many years and often times go unnoticed until vision testing by your doctor.
Cataract Overview
Cataract Surgery in Knoxville
Through continued advancements and the constant introduction of new technologies in vision care, there are ever expanding opportunities and new products available to the patient. While this is an amazing time of new innovation, it can also be confusing and daunting for patients to navigate their way through all the options and find what is best for them. At University Eye Specialists, we strive to offer our patients the very best in vision care, from compassionate and well-trained providers and staff, to state of the art techniques and testing modalities, all geared towards obtaining your best vision. Cataract surgery to remove the clouded lens and replace it with a clear artificial lens is performed as a simple outpatient procedure and will usually allow you to return to most of your routine activities shortly thereafter. While surgery is the only way to remove a cataract and clear your vision, there are several treatment options now available that may determine your level of dependence on glasses after surgery. You can explore some of these options here and will have a chance to discuss these further with your surgeon, if desired.
In general, cataract surgery is quick, painless and involves the use of a topical anesthetic as well as light sedation. Phacoemulsification is the most commonly used method for cataract removal in the United States today. The process involves the use of an instrument with a small ultrasonic tip placed through a microincision created by a metal or diamond blade, which is now around 1/10 of an inch. The new lens is then delivered through the same small incision and centered to allow clearer vision. The incision has become smaller over the past two decades and offers a significant advantage over previous methods, whereby the cataract had to be removed intact through a much larger incision of around ½ an inch. Recently, the option for creating this incision, as well as incising the capsule and lens, called Femtosecond Laser Assisted Cataract Surgery (FLACS) has become available using a laser, albeit at a much greater cost to the patient, yet without a significant benefit over conventional cataract surgery to justify this additional cost. At University Eye Specialists, we continually monitor and test new technologies to update our techniques and instrumentation in order to provide you with products and services with clear advantages which we believe in.
See if you are a good candidate for cataract surgery with our self-test.
Intraocular Lens (IOL) Options
Standard Lens Options
Monofocal Aspheric Lenses (i.e. Alcon SN60WF or AMO Tecnis ZCBOO):
These lenses give excellent sharp vision at a single focal point and can be targeted to be in focus at distance or near depending on the patient’s preoperative preference. They work extremely well for monovision (one eye for distance and one eye for near) in those who have been accustomed to using contact lenses in this fashion. However, they do not correct for astigmatism.
Premium Lens Options
Toric Monofocal Aspheric Lenses (i.e. Alcon SN6AT3 or AMO Tecnis ZCT150):
These lenses are similar to lenses in #1, with the additional ability to correct for regular astigmatism, thus significantly reducing overall blur caused by astigmatism.
Accommodative Lenses (i.e. B&L Crystalens or B&L Trulign Toric):
These lenses use a monofocal lens supported by hinged plate haptics to allow for flexing and changing of the effective lens position in order to focus images at different distances. However, normal healing of the lens capsule limit the amount of flexion with time and reduce the accommodative power and thus the ability to change focus. This lens is also available in a Toric model to treat astigmatism.
Multifocal Aspheric Lenses (i.e. Alcon ReSTOR or AMO ZLB00):
These lenses use diffractive optics with concentric rings on the lens surface to direct light rays from multiple focal points, thereby blending images at distance and near to allow for a greater range of vision without glasses. However, they can diminish image sharpness and cause halos around light sources at night to a variable degree. They do not correct for astigmatism.
Extended Range Aspheric Lenes (ie. AMO Symfony and AMO Symfony Toric):
These lenses were released in the fall of 2016 and are similar to multifocal IOLs as they use diffractive optics, but they also use a newer technology which improves image contrast and allows for an extended range of focus from distance to intermediate and even some near, while reducing the incidence of halos around light sources at night. This lens is also available in a Toric model to treat astigmatism.
All of these lens options have pros and cons, but knowing your visual goals and expectations will allow you and your doctor to obtain the best results possible.
Post Surgery
Visual improvement typically occurs within the first 24 hours after surgery, but will likely continue to improve over the next week. Post-operative symptoms can include itching, irritation, tearing, and sensitivity to light, but should all be mild and transient. Eye drops will be prescribed in order to prevent infection and reduce inflammation. Eyeglasses or sunglasses should be worn to protect the eye during the day and a clear shield will be provided for use while sleeping. Limitations are generally light and allow you to perform most activities except for swimming or lifting heavy objects, but you must avoid pressing or rubbing the eye for several weeks. Full recovery usually occurs within 4 weeks.
Costs
Medicare and third party insurers typically pay for cataract surgery when medically necessary. However, only the standard monofocal intraocular lens (#1 above) is covered by insurance, with all other premium lens options provided at an additional cost. University Eye Specialists offers several options to assist with the cost of surgery and lens options. Our staff is available to discuss all of these options.
